Public Health Assessments

Hazardous Substances and Sites

The Missouri Department of Health and Senior Services (DHSS) has a cooperative agreement with the Agency for Toxic Substances and Disease
Registry (ATSDR), a federal health agency, to conduct public health assessments for each site listed on the Environmental
Protection Agency's National Priorities List. A public health assessment reviews available
information about hazardous substances at a site and evaluates whether exposure to them might cause any harm to people.

Conducting a public health assessment is a multiple-phase process. First, all existing environmental data are brought together and reviewed to determine
where contamination exists and how people could be exposed to that contamination. Community concerns about how a site affects their health or quality of life
are also gathered and reviewed. Second, potential health effects associated with exposure to the particular contaminants found at the site are reviewed. Existing
scientific information is reviewed for this part of the assessment. Existing information may include results of medical, toxicological and epidemiological studies
as well as data collected in disease registries. The exposure determination and health effects review are brought together in a conclusion. The conclusion states
the level of health threat, if any, posed by exposure to a site. Recommendations are provided to agencies and companies to eliminate or reduce contamination. In
addition, recommendations are given to help people eliminate or reduce their exposure. A public health action plan is proposed, as well.

The health assessment process is an interactive one. Information is solicited from numerous city, state and federal agencies, the companies responsible for
cleaning up the site, and the community. The assessment is shared with all parties who contributed to make sure that the data provided is accurate and current.
To ensure that the assessment responds to the community's health concerns, an early version is also distributed to the public for their comments. All the comments
received from the public are responded to in the final version of the report.